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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343610866
Report Date: 10/12/2022
Date Signed: 10/12/2022 09:11:06 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/29/2022 and conducted by Evaluator Jeremey McClain
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20220929093915
FACILITY NAME:FAMILY MATTERS CHILD CARE CENTERFACILITY NUMBER:
343610866
ADMINISTRATOR:NELSON, GINAFACILITY TYPE:
830
ADDRESS:5452 14TH AVE.TELEPHONE:
(916) 457-4067
CITY:SACRAMENTOSTATE: CAZIP CODE:
95820
CAPACITY:16CENSUS: 5DATE:
10/12/2022
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Niecia LewisTIME COMPLETED:
09:30 AM
ALLEGATION(S):
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Child in care sustained injuries due to lack of supervision
Staff did not meet the needs of child in care
INVESTIGATION FINDINGS:
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On October 12th, Licensing Program Analyst (LPA) Jeremey McClain met with Licensing Representative Niecia Lewis for the purpose of delivering findings for a complaint investigation. LPA observed five infants supervised by two staff members. It was alleged that that a child in care sustained multiple injuries while in care due to inadequate supervision. There was also an allegation that the needs of a child in care were not met, and that they were left in soiled clothing and bedding. During the investigation, LPA conducted interviews with staff and current parents. LPA made observations of children’s bedding and staff’s supervision of children. LPA also reviewed children’s files. Evidence gathered was not sufficient to corroborate either allegation, and they can neither be confirmed or dismissed. The preponderance of evidence standard has not been met; therefore, the allegations are determined to be unsubstantiated.

There were no Title 22 deficiencies as a result of the investigation. LPA reviewed this report with Licensing and conducted and exit interview. LPA provided a Notice of Site Visit (that must be posted for 30 days) and provided Appeal Rights.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClainTELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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